A pilot randomized controlled trial of 6-week combined exercise program on fasting insulin and fitness levels in individuals with spinal cord injury

  • Dong-Il Kim
  • J. Andrew Taylor
  • Can Ozan Tan
  • Hyuna Park
  • Ji Young Kim
  • Sang-Yong Park
  • Kyong-Mee Chung
  • Young-Hee Lee
  • Bum-Suk Lee
  • Justin Y. JeonEmail author
Original Article



The aim of this randomized controlled trial study was to investigate the effect of combined exercise program on the fasting insulin and fitness levels of people with spinal cord injury (SCI).


A total of 19 individuals with SCI participated in a combined exercise program consisting of aerobic and resistance exercises for 60 min per day, 3 days per week for 6 weeks. Peak oxygen consumption, body mass index, percent body fat, waist circumference, shoulder abduction and adduction, shoulder flexion and extension, elbow flexion and extension, fasting insulin levels, and homeostasis model assessment of insulin resistance (HOMA-IR) levels were measured at baseline and after the intervention.


The 6-week exercise program significantly decreased the average fasting insulin (baseline: 7.5 ± 4.7 µU/ml vs. post-intervention: 4.5 ± 2.2 µU/ml, p < 0.05) and HOMA-IR (baseline: 1.5 ± 1.0 vs. post-intervention: 0.9 ± 0.4, p < 0.05) in the exercise group, whereas there was no change in control group (between group difference, mean fasting insulin: − 3.2 µU/ml, p = 0.003; mean HOMA-IR: − 0.66, p = 0.001). In addition, muscle strength of the shoulder flexors, extensors, abductors, adductors, and elbow flexors was significantly improved in the exercise group compared to the controls.


A combined exercise program is effective in decreasing fasting insulin and HOMA-IR levels while improving fitness in those with SCI.

Graphical abstract

These slides can be retrieved under Electronic Supplementary Material.


Spinal cord injury Exercise Body composition Fitness Insulin 

List of Abbreviations


Spinal cord injury


Homeostasis model assessment of insulin resistance


Body mass index

VO2 Peak

Peak oxygen consumption



This research was supported by a Grant (code# 2014007) from the National Rehabilitation Research Institute. This work was supported by the Ministry of Education of the Republic of Korea and the National Research Foundation of Korea (NRF-2016S1A5B5A07916765).

Author contributions

All authors of this research paper have directly participated in the planning, execution, or analysis of the study. All authors of this paper have read and approved the final version submitted.

Compliance with ethical standards

Conflict of interest

No author has any conflict of interest.

Supplementary material

586_2019_5885_MOESM1_ESM.pptx (289 kb)
Supplementary material 1 (PPTX 289 kb)


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  • Dong-Il Kim
    • 1
  • J. Andrew Taylor
    • 2
    • 3
  • Can Ozan Tan
    • 2
    • 4
  • Hyuna Park
    • 5
  • Ji Young Kim
    • 6
  • Sang-Yong Park
    • 7
  • Kyong-Mee Chung
    • 8
  • Young-Hee Lee
    • 9
  • Bum-Suk Lee
    • 10
  • Justin Y. Jeon
    • 5
    Email author
  1. 1.Department of Professional Therapy, Graduate School of Professional TherapyGachon UniversitySeongnamRepublic of Korea
  2. 2.Department of Physical Medicine and RehabilitationHarvard Medical SchoolBostonUSA
  3. 3.Cardiovascular Research LaboratorySpaulding Hospital CambridgeBostonUSA
  4. 4.Cerebrovascular Research LaboratorySpaulding Rehabilitation HospitalBostonUSA
  5. 5.Department of Sport Industry Studies, Exercise Medicine and Rehabilitation LaboratoryYonsei UniversitySeoulKorea
  6. 6.Korea Disabled People’s Development InstituteSeoulKorea
  7. 7.Department of Physical EducationGachon UniversitySeongnamRepublic of Korea
  8. 8.Department of PsychologyYonsei UniversitySeoulKorea
  9. 9.Department of Rehabilitation MedicineYonsei University Wonju College of MedicineWonjuKorea
  10. 10.Department of Rehabilitation MedicineNational Rehabilitation HospitalSeoulKorea

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